Failure to Label Opened Inhaler Medications on Medication Carts
Penalty
Summary
Surveyors identified a deficiency in the facility’s medication labeling practices related to multiple residents’ inhaler medications. During an observation of the first-floor medication cart #2 with an RN, one resident’s Symbicort inhalers were found opened without any label indicating the open or discard dates, despite an active order for Symbicort 160-4.5 mcg/act, 2 puffs inhaled orally twice daily. On the same cart, another resident’s Fluticasone-Umeclidinium-Vilanterol inhaler was also opened and not labeled with an open or discard date, even though there was an active order for one inhalation orally once daily. The RN present stated she was unsure why the opened inhalers were not labeled. On the second floor, during a check of medication cart #1 with another RN, a third resident’s Symbicort, Atrovent (Ipratropium Bromide HFA), and Levalbuterol aerosol inhalers were all opened and not labeled with open or discard dates, despite active orders for Symbicort twice daily, Levalbuterol every 6 hours as needed, and Ipratropium Bromide four times daily. On the same cart, a fourth resident’s Albuterol inhaler was also opened and not labeled with an open or discard date. The RN on the second floor stated that all opened inhalers should be labeled with open dates to ensure they are stored and discarded properly. The facility’s undated Medication Labeling and Storage policy stated that medications and biologicals are to be labeled in a manner consistent with currently accepted pharmaceutical practices and that nursing staff are responsible for maintaining medication storage in a safe manner.
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